| NPI | 1508199548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4490) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT MED-PAC-LIC-651) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2023-06-14 |